One day, just like that, it dawns on you. Suddenly you realize, “I feel empty.” For weeks you may have tried to valiantly push through your days, but the grip of anxiety and depression offered much resistance. Nothing can deplete your spirit quite like depression and anxiety together. These two mental health disorders seem to conspire against you when they co-occur, which, unfortunately, they often do.
We might go about our daily lives feeling under the weather and not really understanding what is causing thoughts such as “I feel empty.” You might initially assume you are fighting a bug or some other medical issue, when in reality dual mental health conditions are at fault. So, get to know the signs of depression and anxiety disorder. In recognizing the symptoms of these disorders, hopefully you will be prompted to reach out to a mental health provider who can guide you back to wellness.
About Co-Occurring Depression and Anxiety
It is eye opening how many of us struggle with mental health conditions, especially anxiety and depression. Separately, these two mental health disorders impact over 56 million Americans each year. When both depression and anxiety are present together it compounds the negative effect, as each disorder will trigger or intensify the other.
Symptoms of anxiety. Anxiety disorder consists of a spectrum of mental health disorders that share certain features, but also are divided into separate disorders under the anxiety disorder umbrella. There are several distinguishing features that help the clinician determine which type of anxiety disorder is present:
- Generalized anxiety disorder. GAD features excessive worrying, feelings of dread and fear, muscle tension, irritability, nausea, insomnia, trouble concentrating.
- Panic disorder. Panic disorder is characterized by sudden and unpredictable feelings of overwhelming fear, heart palpitations, chest tightness or pain, shallow breathing, dizziness.
- Social anxiety. Social anxiety involves the intense and irrational fear of being humiliated, criticized, or judged publicly. People with social anxiety tend to isolate themselves as a result.
- Specific phobia. With phobias, a person exhibits an irrational and intense fear of a thing, place, or situation, resulting in avoidant and isolating behaviors.
- Agoraphobia. When someone is agoraphobic they have intense anxiety symptoms when feeling they are in an unsafe place and do not perceive a way out.
- Trauma disorder. Post-traumatic stress disorder features prolonged symptoms after experiencing or witnessing a traumatic event. Symptoms include flashbacks, nightmares, substance abuse, and avoidant behaviors.
- Obsessive-compulsive disorder. OCD is characterized by irrational worries that are followed by compulsive or repetitive behaviors as a method of quelling the anxiety caused by the worry.
Symptoms of depression: Similarly, depressive disorders also encompass a collection of different presentations of depression based on the unique features:
- Major depressive disorder. MDD features prolonged feelings of sadness or despair, fatigue, sudden weight changes, loss of interest in usual activities, change in sleeping habits, trouble concentrating, and suicidal thoughts.
- Persistent depressive disorder. Also termed dysthymia, this disorder features a milder version of MDD but one that lasts more than two years.
- Postpartum depression. This type of depression affects a mother with feelings of sadness, intense irritability, insomnia, loss of appetite, mood swings, and thoughts of harming baby or self.
- Seasonal affective disorder. Regions that are further from the equator are more prone to people getting seasonal depression when the days are short. Lack of sun exposure can lead to vitamin D deficiency, which is one of the key symptoms behind the depression.
There are many reasons to seek out help for depression and anxiety. For example, someone with co-occurring depression and anxiety are more susceptible to substance abuse. A substance, such as alcohol or prescription drugs, may be misused in an effort to mask the mental health symptoms being experienced. Also, undiagnosed and untreated mental health disorders can result in job loss, damaged relationships, poor health, and isolation.
What is Bipolar Disorder?
One serious mood disorder that has elements of both anxiety and depression is bipolar disorder. Bipolar disorder is characterized by intense shifts in mood that are often unpredictable. Moods alternate between mania and depression, and can be very destabilizing. There are four different ways that bipolar disorder presents. These include:
- Bipolar I
- Bipolar II
- Cyclothymic disorder
- Otherwise unspecified bipolar
Treatment for bipolar disorder is essential. Medications such as antidepressants and mood stabilizers are prescribed for this disorder, along with psychotherapy. In therapy, the individual will learn how to better recognize the signs of an impending episode, learn ways to promote relaxation, and to better manage the oncoming symptoms.
Treatment for Co-existing Anxiety and Depression
Comorbid anxiety and depression present a more complex diagnosis than either one of these disorders on its own. In fact, individuals with both anxiety and depression will usually have a more enhanced severity of symptoms, more functional impairment, and a longer recovery period.
Treating anxiety and depression will rely on foundational methods, such as psychotherapy and medication, as well as adjunctive therapies and lifestyle modifications. During the initial intake interview with a therapist or psychiatrist a thorough evaluation of the presenting issues and symptoms will be conducted. The interview itself can often provide valuable information to assist the therapist in assessing which disorder, the depression or the anxiety, is predominant. Diagnostic criteria provided by the DSM-5, as well as other assessment tools, and any accompanying features help the clinical staff arrive at an accurate diagnosis.
When treating both anxiety and depression it is important that both mental health disorders are treated simultaneously for the best treatment outcome. Treating just one or the other will not be effective, as the remaining disorder will sabotage any gains made in managing the other disorder.
Treatment interventions for individuals with depression and anxiety who say, “I feel empty” will encompass a variety of therapeutic activities. These include:
The core treatment protocol for depression and anxiety continues to center on antidepressant drug therapy. These are antidepressants that have been found to help the symptoms of both disorders. In addition, benzodiazepines can be useful in managing panic disorder.
Cognitive Behavioral Therapy (CBT) is the evidence-based approach most often used for treating anxiety and depression together. CBT helps individuals better cope with stressors, and guides them toward making positive shifts in their thought patterns. If depression and anxiety is the result of a traumatic experience, then prolonged exposure therapy is also beneficial.
Learning methods to self soothe when experiencing anxiety are key to better symptom management. There are several complementary activities included now in mental health treatment programs that teach patients to do exactly that. These may include learning how to practice mindfulness, yoga, and deep breathing techniques.
Diet and Exercise
Nutritional counseling is often included in residential mental health programs, as there is a direct connection between what we eat and our mental health and brain functioning. Exercise is also included, as physical activity can reduce stress and elevate mood.
Patients are taught that regulating the circadian rhythm is essential for improving overall mental wellness and functioning. Sticking to a regular sleep schedule helps the body create a predictable pattern for rest. A minimum of 7 hours of sleep is optimum.
Levels of Care for Treating Depression and Anxiety
When recognizing that the co-occurring anxiety and depression is causing impairment and harming your quality of life, it is helpful to understand the different levels of care available. Mental health treatment generally falls into two categories, outpatient or residential care:
- Outpatient treatment. When you find yourself struggling emotionally, you may first seek out help from your doctor. Mental health conditions often cause physical symptoms, such as fatigue, edginess, sleep problems, or intestinal distress. After the doctor has ordered labs and conducted an exam, he or she may find there is no medical condition present. This is when a referral to a psychiatrist or psychotherapist is made. The mental health provider will then help manage the symptoms by prescribing medication and talk therapy. If the condition worsens and more intervention is needed, the mental health professional might refer you to an outpatient program where you will participate in support groups, individual psychotherapy, and psychosocial education classes for a more intensive approach.
- Residential treatment. A residential mental health program offers a higher level of care than any of the outpatient options. The residential treatment setting allows someone to focus on learning how they can better manage their condition. Without the usual distractions or stress-inducing triggers, the person feels safe in the residential setting. Because the individual will reside at the center for a specified period of time, they will be receiving a higher degree of attention and support. Treatment plans are highly tailored to address the person’s specific mental health needs. Residential programs for depression and anxiety usually provide acute stabilization services for individuals experiencing a psychiatric emergency, such as psychosis or a suicide attempt. Following discharge from the residential program, the individual might step down to an outpatient day program.
Whether receiving outpatient or residential treatment, the objective is the same, to restore mental health functioning and improve quality of life.
Elevation Behavioral Health is a Premier Los Angeles Residential Mental Health Center
Elevation Behavioral Health offers an intimate setting located in a beautiful, tranquil location that allows someone accustomed to saying, “I feel empty,” to find their way back to the fullness of life. Elevation provides a fully customized treatment program that is designed specifically to the individual’s needs. Using a blend of evidence-based therapies and holistic elements, Elevation addresses all aspects of a person, healing mind, body, and spirit.